US10041960B2 - Devices, systems, and methods for measuring blood loss - Google Patents

Devices, systems, and methods for measuring blood loss Download PDF

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US10041960B2
US10041960B2 US14/890,098 US201414890098A US10041960B2 US 10041960 B2 US10041960 B2 US 10041960B2 US 201414890098 A US201414890098 A US 201414890098A US 10041960 B2 US10041960 B2 US 10041960B2
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fluid sample
blood
light
processor
wavelength
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US20160123998A1 (en
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Annette MacIntyre
Lara Brewer
Suzanne Wendelken
Quinn Tate
Soeren Hoehne
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University of Utah Research Foundation UURF
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University of Utah Research Foundation UURF
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    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/72—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving blood pigments, e.g. haemoglobin, bilirubin or other porphyrins; involving occult blood
    • G01N33/721—Haemoglobin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02042—Determining blood loss or bleeding, e.g. during a surgical procedure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14546—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring analytes not otherwise provided for, e.g. ions, cytochromes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • A61M1/006—
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/77—Suction-irrigation systems
    • A61M1/777—Determination of loss or gain of body fluids due to suction-irrigation, e.g. during surgery
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N21/00—Investigating or analysing materials by the use of optical means, i.e. using sub-millimetre waves, infrared, visible or ultraviolet light
    • G01N21/17—Systems in which incident light is modified in accordance with the properties of the material investigated
    • G01N21/25—Colour; Spectral properties, i.e. comparison of effect of material on the light at two or more different wavelengths or wavelength bands
    • G01N21/31—Investigating relative effect of material at wavelengths characteristic of specific elements or molecules, e.g. atomic absorption spectrometry
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/483—Physical analysis of biological material
    • G01N33/487—Physical analysis of biological material of liquid biological material
    • G01N33/49—Blood
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N2333/00—Assays involving biological materials from specific organisms or of a specific nature
    • G01N2333/795—Porphyrin- or corrin-ring-containing peptides
    • G01N2333/805—Haemoglobins; Myoglobins

Definitions

  • This invention relates to devices, systems, and methods for measuring the blood loss of a subject, and more particularly, to devices, systems, and methods for measuring the blood loss of a subject during a medical procedure.
  • IV intravenous
  • a suction canister collects blood, irrigation fluids and other bodily fluids.
  • the current methods for estimating intraoperative blood loss are inaccurate due to the difficulty of determining the amount of blood in the suction canister when the blood is mixed with unknown quantities of other fluids within the suction canister.
  • the blood measurement device for determining the amount of blood of a subject within a fluid sample.
  • the blood measurement device includes a light source, at least one photodetector, and a processor.
  • the light source is configured to selectively generate light at a first wavelength and at a second wavelength different from the first wavelength.
  • the light source and the at least one photodetector are configured for positioning in an operative position. In the operative position, the at least one photodetector is configured to receive at least a portion of the light generated by the light source.
  • the at least one photodetector Upon positioning of the light source and the at least one photodetector in the operative position, the at least one photodetector is configured to produce a first signal indicative of the absorbance of the fluid sample at the first wavelength and a second signal indicative of the absorbance of the fluid sample at the second wavelength.
  • the processor is operatively coupled to the at least one photodetector and is configured to receive the first and second signals from the at least one photodetector. Based upon the received first and second signals, the processor can be configured to determine the concentration of hemoglobin within the fluid sample. Optionally, the processor can be further configured to determine the volume of blood within the fluid sample. Also described is a blood measurement system including the blood loss measurement device and a processor.
  • Each photodetector of the blood loss measurement device can be configured to produce a first signal indicative of the absorbance of the fluid sample at the first wavelength and a second signal indicative of the absorbance of the fluid sample at the second wavelength.
  • the processor can be in operative communication with the at least one photodetector, and the processor can be configured to receive the first and second signals from each photodetector.
  • the processor can be configured to determine the concentration of hemoglobin within the fluid sample.
  • the processor can be further configured to determine the volume of the fluid sample.
  • the processor can be still further configured to determine the blood loss of the subject.
  • blood measurement systems including the blood measurement device and a container, such as a suction canister.
  • a container such as a suction canister.
  • portions of the blood measurement device can be selectively insertable within a fluid sample positioned within the suction canister.
  • the methods can include operatively positioning the blood measurement device relative to a fluid sample and using the blood measurement device (alone or in combination with conventional methods) to determine the concentration of hemoglobin within the fluid sample.
  • the methods can include administering one or more reagents to the interior space of the suction canister.
  • the reagents can be configured to convert hemoglobin within the fluid sample into either methemoglobin or sulphemoglobin.
  • the methods can optionally include the step of delivering an anti-coagulant to the fluid sample.
  • FIG. 1 depicts an exemplary blood measurement system as disclosed herein.
  • FIG. 2 depicts another exemplary blood measurement system as disclosed herein, showing a base element having first and second members.
  • FIG. 3 schematically depicts another exemplary blood measurement system as disclosed herein, showing a single pair of optical fibers positioned within a sample fluid as disclosed herein.
  • FIG. 4 schematically depicts an exemplary blood measurement system as disclosed herein.
  • FIG. 5 depicts an exemplary process of calculating the updated hemoglobin levels and blood loss for a subject during a surgical procedure.
  • EBL refers to “estimated blood loss”
  • EBV refers to “estimated subject blood volume”
  • Hgb refers to the hemoglobin concentration of the subject.
  • FIG. 6 depicts an exemplary relationship among the monitoring devices, system, storage and display disclosed herein.
  • FIG. 7 depicts a linear regression analysis of predicted hemoglobin concentration and measured hemoglobin concentration using an exemplary system as disclosed herein. R 2 was calculated as 0.80.
  • FIG. 8 depicts a Bland-Altman analysis of predicted patient hemoglobin and measured patient hemoglobin using an exemplary system as disclosed herein.
  • Ranges can be expressed herein as from “about” one particular value, and/or to “about” another particular value. When such a range is expressed, another aspect includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another aspect. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint.
  • the terms “optional” or “optionally” mean that the subsequently described event or circumstance may or may not occur, and that the description includes instances where said event or circumstance occurs and instances where it does not.
  • a “subject” is an individual and includes, but is not limited to, a mammal (e.g., a human, horse, pig, rabbit, dog, sheep, goat, non-human primate, cow, cat, guinea pig, or rodent), a fish, a bird, a reptile or an amphibian.
  • a mammal e.g., a human, horse, pig, rabbit, dog, sheep, goat, non-human primate, cow, cat, guinea pig, or rodent
  • the term does not denote a particular age or sex. Thus, adult and newborn subjects, as well as fetuses, whether male or female, are intended to be included.
  • a “patient” is a subject afflicted with a disease or disorder.
  • patient includes human and veterinary subjects.
  • the term “subject” can be used interchangeably with the term “patient.”
  • Described herein with reference to FIGS. 1-6 are devices, systems, and methods for measuring blood loss within a subject. It is contemplated that the disclosed devices, systems, and methods can provide a more accurate measurement of blood loss during a surgical procedure than conventional devices, systems, and methods. As further disclosed herein, the disclosed systems and methods can be used to iteratively estimate the hemodilution of a subject based on the kinetics of intravenous fluid administration and blood loss. It is further contemplated that the disclosed blood measurement devices and systems can directly measure the amount of blood in a suction canister based upon the estimated hemodilution of the subject.
  • the disclosed system can iteratively estimate the hemoglobin status of the subject intraoperatively by taking into account a baseline estimation of the patient's intravascular blood volume (EBV) and preoperative hemoglobin status, the volume of intravenous fluids administered to the subject, as well as the volume and hemoglobin concentration of the fluid within the suction canister.
  • the updated estimated hemoglobin status of the subject can then be used to accurately calculate the new volume of blood loss in the suction canister.
  • the disclosed devices, systems, and methods can optionally employ algorithms to determine the concentration of hemoglobin within a fluid sample and/or the blood loss experienced by a subject during a medical procedure.
  • the disclosed devices, systems, and methods can be used in conjunction with any conventional method of predicting a subject's hemoglobin concentration and/or the volume of a fluid sample containing the blood of a subject.
  • exemplary algorithms for determining hemoglobin concentration and blood loss are provided herein, it is understood that the devices, systems, and methods disclosed herein are not restricted to use with particular algorithms.
  • the disclosed devices, systems, and methods can be used in conjunction with conventional methods for determining one or more of the following: the subject's preoperative hemoglobin concentration; an updated hemoglobin concentration of the subject, determined from a subject's blood sample; an updated hemoglobin concentration of the subject, based upon an estimate provided by a practitioner (e.g., an anesthesiologist); or an updated hemoglobin concentration of the subject, based upon a continuous, non-invasive method as is known in the art.
  • the preoperative hemoglobin concentration of the subject can be averaged with the updated hemoglobin concentration to permit determination of the amount of blood lost by the subject. It is further contemplated that the averaged hemoglobin concentration can be provided to a processor as disclosed herein in the form of one or more user inputs.
  • a blood measurement device 10 can comprise means for measuring the concentration of hemoglobin within the fluid sample 12 .
  • at least a portion of the fluid sample can comprise blood of a subject.
  • the means for measuring the concentration of hemoglobin can comprise at least one photodetector 30 .
  • the at least one photodetector 30 can comprise at least one photometer as is known in the art.
  • the means for measuring the concentration of hemoglobin can further comprise a light source 40 .
  • the light source 40 can be configured to generate light at a first wavelength and at a second wavelength different from the first wavelength. It is contemplated that the light source 40 can comprise any conventional light source that is capable of generating light at multiple wavelengths.
  • the light source 40 and the at least one photodetector 30 can be configured for positioning in an operative position. In the operative position, the at least one photodetector 30 can be configured to receive at least a portion of the light generated by the light source 40 . It is contemplated that the at least one photodetector 30 can be configured to detect the absorbance of the fluid sample 12 at the first wavelength and the second wavelength.
  • the first wavelength can range from about 500 nm to about 600 nm and the second wavelength can range from about 850 nm to about 900 nm.
  • the first wavelength can be about 525 nm and the second wavelength can be about 870 nm.
  • the at least one photodetector 30 can be configured to produce a first signal indicative of the absorbance of the fluid sample 12 at the first wavelength and a second signal indicative of the absorbance of the fluid sample at the second wavelength.
  • the blood measurement device 10 can further comprise a processor 200 as is conventionally known in the art.
  • the processor 200 can be provided in the form of a computer, and the processor 200 can be in operative communication with a memory (or other storage device) and/or a display as are known in the art.
  • the memory can optionally store software that, when executed, is configured to perform one or more of the steps and calculations disclosed herein. It is further contemplated that the memory can store historical information related to the hemoglobin concentration and/or blood loss of particular patients.
  • the processor 200 can be provided as a microcontroller that is secured to or housed within a portion of the device 10 .
  • the processor 200 can comprise one or more modules for determining at least one of the estimated blood loss (EBL) of the subject, the hemoglobin concentration (Hgb) of the fluid sample, and the volume of the fluid sample.
  • the processor 200 can be configured to receive one or more inputs from a user or a memory indicative of at least one of a previously measured EBL of the subject, a previously measured hemoglobin concentration of the fluid sample, a previously measured volume of the fluid sample, a volume of the container (e.g., canister) in which the fluid sample is positioned, the rate of IV fluid (or other fluid) administration, the sex of the subject, the weight of the subject, the age of the subject, and the like.
  • the processor 200 can be positioned in operative communication with a user interface that is configured to receive the one or more inputs from a user.
  • the display and/or user interface can be secured to or defined thereon a portion of the device 10 .
  • the processor 200 can be operatively coupled to the at least one photodetector 30 .
  • the processor 200 can be configured to receive the first and second signals from the at least one photodetector 30 . Based upon the received first and second signals, the processor 200 can be configured to determine the concentration of hemoglobin within the fluid sample 12 .
  • the processor 200 can be configured to visually depict the determined hemoglobin concentration of the fluid sample on a display positioned in operative communication with the processor.
  • At least a portion of the blood measurement device 10 can be configured to be discarded with the fluid sample (and, optionally, the container in which the fluid sample was positioned).
  • the entire blood measurement device 10 can be reusable.
  • the at least one photodetector 30 can comprise an array of a plurality of photodetectors. It is contemplated that the at least one photodetector 30 can comprise from about 1 photodetector to about 80 photodetectors. However, it is understood that any selected number of photodetectors can be used as disclosed herein. It is further contemplated that, in a blood loss measurement device 10 configured to measure volume, the at least one photodetector 30 can comprise at least 10 photodetectors. In exemplary aspects, it is contemplated that the array of photodetectors 30 can be radially spaced from the light source 40 by a distance ranging from about 0.05 mm to about 0.2 mm.
  • the light source 40 can comprise at least one light-emitting diode (LED) 42 .
  • the at least one LED 42 can comprise from about 1 LED to about 160 LEDs. It is contemplated that, when the blood loss measurement device 10 is configured to measure a volume of the fluid sample 12 , the at least one LED 42 can comprise at least 10 LEDs. In exemplary aspects, it is contemplated that at least one LED 42 can be configured to emit light at the first wavelength and at least one LED can be configured to emit light at the second wavelength. Alternatively, it is contemplated that at least one LED 42 can be configured to selectively emit light at both the first and second wavelengths. It is further contemplated that each LED 42 of the at least one LED can be configured for selective activation.
  • the at least one LED 42 comprises a plurality of LEDs
  • the LEDs can be provided in the form of an array.
  • the plurality of LEDs 42 can be positioned in substantial alignment within a single row, and the row can be oriented substantially parallel to a vertical axis 21 .
  • the blood measurement device 10 can further comprise a base element 80 configured for selective insertion within the fluid sample 12 .
  • the light source 40 can be operatively coupled to the base element 80 , and the base element 80 and the light source 40 can be configured for selective insertion within the fluid sample as a unitary structure.
  • the at least one photodetector 30 can be operatively coupled to the base element 80 , and the base element and the at least one photodetector can be configured for selective insertion within the fluid sample as a unitary structure.
  • first and second base elements 80 can be provided, with the first base element being operatively coupled to the light source 40 and the second base element being operatively coupled to the at least one photodetector 30 .
  • the base element 80 (or base elements) can function as a dipstick-type element that can be selectively placed into a fluid sample to permit generation of light at the first and second wavelengths by the light source 40 and/or measurement of absorbance by the at least one photodetector 30 as disclosed herein.
  • the base element 80 can be configured for selective attachment to a suction canister 20 or other container in which the fluid sample is positioned.
  • the base element 80 can have first and second opposed members 82 , 84 .
  • the first and second opposed members 82 , 84 can at least partially define a sample chamber 50 configured to receive a portion of the fluid sample.
  • the light source 40 can be operatively coupled to the first member 82 of the base element 80
  • the at least one photodetector 30 can be operatively coupled to the opposed second member 84 of the base element.
  • the light source 40 comprises a plurality of LEDs 42 and the at least one photodetector comprises a plurality of photodetectors 30
  • the LEDs and the photodetectors can be provided in an alternating pattern along a length of each of the first member 82 and the second member 84 .
  • the LEDs 42 and photodetectors 30 can be coupled to the first and second members 82 , 84 such that each photodetector is positioned radially across from a corresponding LED.
  • the base element 80 , the light source 40 , and the at least one photodetector 30 can be configured for selective insertion within the fluid sample as a unitary structure.
  • the first and second opposed members 82 , 84 can be spaced from one another by a distance ranging from about 0.05 mm to about 0.2 mm, thereby maintaining the desired spacing between the light source 40 and the at least one photodetector 30 .
  • the base element 80 and any other components of the device 10 that are operatively coupled to the base element can be reusable (i.e., configured for multiple uses).
  • the base element 80 can be inserted into a first fluid sample to permit measurement of the hemoglobin concentration of the first fluid sample, removed from the first fluid sample, and then inserted into a second fluid sample to permit measurement of the hemoglobin concentration of the second fluid sample.
  • the blood measurement device 10 can further comprise a plurality of pairs of opposed optical fibers 90 .
  • each pair of optical fibers can comprise a first optical fiber 90 a operatively coupled to a corresponding LED 42 of the plurality of LEDs and a second optical fiber 90 b operatively coupled to a corresponding photodetector 30 of the plurality of photodetectors.
  • the plurality of pairs of opposed optical fibers 90 can be configured for selective insertion within the fluid sample. In the operative position, it is contemplated that the plurality of photodetectors 30 and the plurality of LEDs 42 will not be in fluid communication with (i.e., do not contact) the fluid sample.
  • the plurality of pairs of opposed optical fibers 90 can be selectively detachable from at least one of the light source 40 (LEDs 42 ) and the at least one photodetector 30 .
  • each optical fiber of the plurality of pairs of opposed optical fibers can comprise a receiving end 92 and an opposed transmitting end 94 .
  • the receiving end 92 a of the first optical fiber 90 a of each pair of optical fibers can be configured to receive light from a corresponding LED of the plurality of LEDs
  • the transmitting end 94 a of the first optical fiber of each pair of optical fibers can be configured to transmit the received light (from the LED) within the fluid sample
  • the receiving end 92 b of the second optical fiber 90 b of each pair of optical fibers can be configured to receive light transmitted by the transmitting end 94 a of an opposed first optical fiber (and that is not absorbed by the fluid sample)
  • the transmitting end 94 b of the second optical fiber of each pair of optical fibers can be configured to transmit the received light (from the receiving end 92 b ) to a corresponding photodetector 30 of the plurality of photodetectors.
  • the transmitting end 94 a of the first optical fiber 90 a of each pair of optical fibers can be spaced from the receiving end 92 b of a corresponding second optical fiber 90 b by a selected distance.
  • the selected distance can range from about 0.05 mm to about 0.2 mm.
  • the processor 200 can be configured to receive at least one input indicative of a volume of the sample fluid.
  • a user of the blood measurement device 10 can provide an input corresponding to the volume of the sample fluid.
  • the blood measurement device 10 can be configured to determine the volume of the sample fluid.
  • the photodetectors of the array of photodetectors can be spaced relative to a vertical axis 21 that is in alignment with the directional force of gravity.
  • each photodetector 30 of the array of photodetectors can be configured to produce a transmittance signal indicative of the transmittance of light measured by the photodetector. It is contemplated that the processor 200 can be configured to receive the transmittance signal from each photodetector 30 .
  • the processor 200 can be configured to associate the transmittance signal produced by each respective photodetector 30 of the array of photodetectors with a position of the photodetector relative to the vertical axis 21 . It is still further contemplated that the processor 200 can be configured to determine the highest position at which a photodetector 30 of the array of photodetectors produced a transmittance signal indicative of a transmittance of less than 100%. In operation, it is contemplated that the highest position at which a photodetector 30 of the array of photodetectors produced a transmittance signal indicative of a transmittance of less than 100% can correspond to the height of the fluid sample.
  • the processor 200 can be configured to determine the volume of the fluid sample based upon the height of the fluid sample.
  • a user can input information describing the dimensions, shape, and/or orientation of the container in which the fluid sample is positioned, thereby permitting the processor to determine the volume of the fluid sample based upon the height of the fluid sample.
  • each photodetector 30 of the array of photodetectors can be configured to detect the transmittance of light at a respective position relative to the vertical axis 21 .
  • the photodetectors 30 can be spaced relatively farther apart proximate a bottom portion of the fluid sample and can be spaced relatively closer together proximate a top portion of the fluid sample.
  • the photodetectors 30 can be spaced relatively farther apart proximate a bottom surface of the suction canister and can be spaced relatively closer together proximate a top opening of the suction canister, thereby ensuring that the volume of the fluid sample can be accurately assessed in a truncated cone-shaped canister.
  • the subject's hemoglobin at previously measured time (t ⁇ 1) can correspond to one of: the subject's preoperative hemoglobin concentration; an updated hemoglobin concentration of the subject, determined from a subject's blood sample; an updated hemoglobin concentration of the subject, based upon an estimate provided by a practitioner (e.g., an anesthesiologist); or an updated hemoglobin concentration of the subject, based upon a continuous, non-invasive method as is known in the art. It is contemplated that, when an updated hemoglobin concentration of the subject is determined, the preoperative hemoglobin concentration of the subject can be averaged with the updated hemoglobin concentration to obtain the subject's hemoglobin at previously measured time (t ⁇ 1).
  • the blood measurement device 10 can comprise a power source 70 positioned in operative communication with the at least one photodetector 30 and the light source 40 .
  • the power source 70 can be positioned in operative communication with the at least one photodetector 30 and the light source 40 through conventional wiring 72 .
  • the power source 70 can provide power through wireless transmission means as are known in the art.
  • the power source 70 can be any conventional power source as is known in the art.
  • the power source can comprise a battery.
  • the power source can comprise a DC power source.
  • the power source can comprise an AC power source.
  • the blood measurement device 10 can optionally be configured to create a feedback loop at any given time between the calculated patient hemoglobin concentration and the hemoglobin concentration and volume of the sample fluid, thereby resulting in a continuous display of estimated patient blood loss.
  • the results can be transmitted to a memory and/or display that are in communication with the processor 200 .
  • patient hemoglobin concentration data can be determined using conventional methods and provided manually as an input to the processor 200 .
  • the blood measurement system 100 can comprise the blood measurement device 10 and a container, such as, for example and without limitation, a suction canister 20 .
  • a container such as, for example and without limitation, a suction canister 20 .
  • the container can be any conventional container that is configured to receive a fluid sample.
  • the container can be a cell saver, which is configured to clean a fluid sample to permit delivery of the fluid sample to a patient.
  • the suction canister 20 can have a central axis that, during use, is generally axially aligned with the vertical axis 21 .
  • the suction canister 20 can have a wall 22 with an internal surface 24 and an external surface 26 .
  • the internal surface 24 of the suction canister 20 can define an interior space 25 of the suction canister. It is contemplated that the interior space 25 of the suction canister 20 can be configured to receive the fluid sample 12 .
  • the suction canister 20 can comprise conventional plastic materials, including, for example and without, transparent plastic materials.
  • the suction canister 20 can be provided with volume measurement lines and other measurement lines and markings as are conventionally known in the art.
  • the suction canister 20 can be configured for operative coupling to one or more sections of suction tubing as are conventionally used during surgical procedures to facilitate transport of bodily fluids and/or irrigation fluids to the suction canister. It is further contemplated that the suction canister 20 can have any conventional shape, including, for example and without limitation, a substantially cylindrical shape. It is still further contemplated the suction canister 20 can have any selected dimensions. In exemplary aspects, it is contemplated that the suction canister 20 can have a volume ranging from about 0.5 Liter to about 5 Liters.
  • the canister 20 can define one or more receptacles that are configured to receive at least a portion of the light source 40 . It is further contemplated that the canister 20 can further define one or more receptacles that are configured to receive at least a portion of the at least one photoreceptor 30 . It is still further contemplated that the receptacles in which the light source 40 and the at least one photoreceptor are received can be positioned to receive the light source and the at least one photoreceptor in the operative position, as further disclosed herein.
  • the canister 20 can define one or more receptacles that are configured to receive portions of a base element 80 as disclosed herein.
  • the base element comprises first and second members 82 , 84 as disclosed herein
  • the canister 20 can define a first receptacle configured to receive a portion of the first member 82 and a second receptacle configured to receive a portion of the second member 84 , with the first and second receptacles being spaced to maintain a desired separation between the light source 40 and the at least one photoreceptor 30 .
  • the canister 20 can comprise a lid configured to enclose a top opening of the canister.
  • the lid of the canister 20 can define at least one opening configured to receive one or more portions of the blood measurement device 10 , including, for example and without limitation, the light source 40 , the at least one photodetector 30 , an optical fiber 90 , and the wiring 72 .
  • the at least one photodetector 30 and the light source 40 are positioned in the operative position, it is contemplated that at least a portion of the wiring 70 can be positioned within the interior space 25 of the canister 20 .
  • At least one photodetector 30 and the light source 40 are positioned in the operative position, at least a portion of the wiring 70 can be positioned outside the interior space 25 of the canister 20 and, optionally, can be positioned externally to the canister.
  • the at least one photodetector 30 and the light source 40 can be selectively operatively coupled to the wall 22 of the suction canister 20 .
  • the at least one photodetector 30 and/or the light source 40 can optionally be positioned within a central portion of the interior space 25 of the suction canister 20 (and radially spaced from the wall 22 of the suction canister).
  • the at least one photodetector 30 and/or the light source 40 can be secured to a base element 80 that is configured for selective insertion within the sample fluid within the suction canister 20 .
  • the blood measurement device 10 can comprise a sample chamber 50 positioned within the interior space 25 of the suction canister 20 .
  • the sample chamber 50 corresponds to the three-dimensional volume defined between the light source 40 and the at least one photodetector 30 .
  • the sample chamber 50 can be configured to receive a portion of the fluid sample within the interior space 25 of the suction canister 20 .
  • the radial dimension of the sample chamber 50 can generally correspond to the distance light at the first and second wavelengths can travel in whole blood and, generally, can range from about 0.05 mm to about 0.20 mm, as further disclosed herein.
  • the sample chamber 50 can be at least partially open on two opposed sides to facilitate fluid diffusion and mixing of the fluid sample.
  • the sample chamber 50 can have a width (measured circumferentially at a selected radial distance from the central axis (shown in substantial alignment with vertical axis 21 ) of the canister 20 ) ranging from about 2 to about 15 mm. It is further contemplated that, in exemplary aspects, the width of the sample chamber 50 can be about 5 mm.
  • one or more components of the blood measurement device 10 can be integrally formed with the canister 20 .
  • the at least one photodetector 30 can be integrally formed with the wall 22 of the canister 20 .
  • the at least one photodetector 30 can be connected to the internal surface 24 or external surface 26 of the wall 22 of the suction canister 20 such that the at least one photodetector 30 can receive light from within the canister.
  • the light source 40 can be integrally formed with the wall 22 of the canister 20 .
  • the light source 40 can be mounted to the internal surface 24 or external surface 26 of the wall 22 of the suction canister 20 such that the light source can transmit light into the canister.
  • at least a portion of the wiring 72 of the blood measurement device 10 can be positioned within the wall 22 of the suction canister 20 .
  • at least a portion of the optical fibers 90 disclosed herein can be integrally formed (for example, embedded within) the wall 22 , bottom portion, and/or lid of the canister 20 .
  • the at least one photodetector 30 can comprise at least one bio-chemical receptor affixed to the internal surface 24 of the wall 22 of the suction canister 20 .
  • light-transmitting paint or film i.e., paints or films that permit transmission of light
  • paints or films that permit transmission of light can be selectively applied to portions of the wall 22 of the suction canister 20 and/or portions of the blood measurement device to permit transmission of light within and through canister 20 .
  • at least one of the light source 40 and the at least one photodetector 30 can be positioned out of fluid communication with (i.e., not contact) the fluid sample.
  • the light source 40 can be configured for positioning within the fluid sample and the at least one photodetector 30 can be positioned external to the canister but proximate to the wall of the canister such that each photodetector is configured to receive light transmitted through the light-transmitting paint or film.
  • the light source 40 can be configured for positioning proximate the portions of the wall provided with light-transmitting paint or film such that the light-transmitting material of the canister receive at least a portion of the light transmitted by the light source
  • the at least one photodetector 30 can be configured for positioning within the canister proximate the wall of the canister such that each photodetector is positioned to receive light transmitted through the light-transmitting material.
  • light-transmitting paint or film can be selectively applied to portions of a base element 80 as disclosed herein.
  • at least one of the first and second members 82 , 84 of a base element can be provided with light-transmitting material in selected areas.
  • the blood measurement system 100 can comprise a housing 60 configured to receive at least a portion of the suction canister 20 .
  • the housing 60 can optionally comprise a frame 62 that is configured to surround at least a portion of the wall 22 of the suction canister 20 . It is contemplated that the housing 60 can be configured to support and/or stabilize the suction canister 20 in an operative position during a medical procedure.
  • the power source 70 can be positioned within and/or coupled to the housing 60 .
  • the blood measurement system 10 can comprise a stirrer positioned within the interior space 25 of the suction canister 20 .
  • the stirrer can be a magnetic stirrer as is known in the art.
  • the stirrer can be any conventional stirrer as is known in the art.
  • the stirrer can be configured for selective activation.
  • the stirrer can be positioned proximate the bottom surface of the suction canister 20 .
  • the blood measurement system 100 can further comprise a drip counter 150 configured for communication with an intravenous (IV) fluid delivery element, such as, for example and without limitation, an IV bag as is known in the art.
  • IV intravenous
  • the drip counter 150 can be configured to produce a volume signal indicative of the volume of IV fluid dispensed from the IV fluid delivery element and/or a delivery rate signal indicative of the rate at which IV fluid is dispensed from the IV fluid delivery element.
  • the drip counter 150 can be positioned in operative communication with the processor 200 such that the processor is configured to receive the volume signal and/or the delivery rate signal.
  • the volume and/or rate information can be entered manually by a user of the disclosed system 100 .
  • the blood measurement system can optionally comprise a plurality of blood measurement devices that have a common processor or, alternatively, that have discrete processors that are in operative communication with each other.
  • the blood measurement system can comprise a plurality of containers (e.g., a plurality of suction canisters 20 ), with a blood measurement device being configured for selective positioning relative to a respective container. It is contemplated that such a configuration can permit determination of comprehensive blood loss information in circumstances when more than one container is used to collect fluids during a single medical procedure.
  • the disclosed blood measurement devices and systems 10 , 100 can be used to measure the amount of blood within a fluid sample.
  • the disclosed blood measurement devices and systems 10 , 100 can be used to measure the blood loss of a subject during a medical procedure, such as, for example and without limitation, a surgical procedure.
  • the blood measurement devices and systems 10 , 100 can be configured to repeatedly measure the hemoglobin concentration of the fluid sample within a suction canister 20 , as well as the volume of the sample fluid within the suction canister.
  • a method of measuring the amount of blood of a subject within a fluid sample can comprise operatively positioning the blood measurement device relative to the fluid sample and using the blood measurement device to determine the concentration of hemoglobin within the fluid sample. More specifically, the method can comprise positioning the light source and the at least one photodetector in the operative position relative to the fluid sample.
  • the method can further comprise selectively activating the light source to sequentially generate light at the first and second wavelengths.
  • the method can further comprise receiving the transmitted light using the at least one photodetector.
  • the method can still further comprise, through the processor, receiving the first and second output signals of the at least one photodetector and determining the hemoglobin concentration within the fluid sample.
  • the method can comprise, through the processor, determining the volume of blood within the fluid sample.
  • the method can comprise, through the processor, determining the volume of the fluid sample.
  • the method can comprise, through the processor, receiving an input indicative of the volume of the fluid sample.
  • the method can optionally comprise, through the processor, receiving an input indicative of a starting (or other previously measured) hemoglobin concentration of the subject.
  • the hemoglobin concentration of the fluid sample within the suction container 20 can be measured through one or more hemoglobinometry techniques as are known in the art. Generally, these known color or light-intensity matching techniques can be used to measure the concentration of methemoglobin or sulphemoglobin, which provide an indication of the overall hemoglobin concentration of the fluid sample within the suction canister 20 .
  • the method of measuring the amount of blood of a subject within a fluid sample e.g., determining the blood loss of the subject
  • the one or more reagents can be configured to convert hemoglobin within the fluid sample into one of methemoglobin and sulphemoglobin.
  • the fluid sample can optionally be positioned within a suction canister 20 as disclosed herein, and the one or more reagents can be added to the suction canister.
  • the one or more reagents (and/or a solution containing such reagents) can be administered to the internal surface 24 of the wall 22 of the suction canister 20 .
  • the one or more reagents can be added to the suction canister 20 (or other container) before the fluid sample is received within the suction canister (or other container).
  • the one or more reagents can be applied to selected surfaces of the blood measurement device 10 that are configured for positioning within the fluid sample.
  • the one or more reagents can be configured to circulate within the fluid sample following contact between the selected surfaces of the blood measurement device 10 and the fluid sample.
  • selected surfaces of a base element 80 as disclosed herein can be coated with the one or more reagents.
  • the reagents (and/or the solution containing the reagents) can be allowed to air-dry.
  • the reagents (and/or a solution containing such reagents) can be provided at a predetermined concentration such that dilution of the reagents and/or solution by the fluid sample can yield a desired reagent concentration.
  • An exemplary method for measuring the methemoglobin concentration within the fluid sample comprises the use of hemiglobincyanide (HiCN; cyanmethamoglobin) as a reagent.
  • HiCN hemiglobincyanide
  • cyanmethamoglobin cyanmethamoglobin
  • the use of hemiglobincyanide as a reagent is described in Zijlstra W G, Van Kampen E. Standardization of hemoglobinometry. I. The extinction coefficient of hemiglobincyanide. Clin Chim Acta. 1960 September; 5:719-26, which is incorporated herein by reference in its entirety.
  • the reagent can comprise sodium azide or sodium lauryl sulphate, which convert the hemoglobin to azidmethemiglobin and hemiglobinsulphate, respectively.
  • Exemplary methods of measuring hemoglobin within the blood using sodium azide are described in Vanzetti G. An azide-methemoglobin method for hemoglobin determination in blood. J Lab Clin Med. 1966 January; 67(1):116-26, which is hereby incorporated herein by reference in its entirety.
  • Exemplary methods of measuring hemoglobin within the blood using sodium lauryl sulphate are described in Oshiro I, Takenaka T, Maeda J. New method for hemoglobin determination by using sodium lauryl sulfate (SLS). Clin Biochem. 1982 April; 15(2):83-8, and in Lewis S M, Garvey B, Manning R, Sharp S A, Wardle J.
  • lysing agents can be added to the solvent.
  • exemplary lysing agents can be selected from the group consisting of desoxycholate, quaternary ammonium salts, and quaternary ammonium surfactants, such as, for example and without limitation, anionic, non-ionic, zwitterionic, and cationic surfactants.
  • compositions can be added per liter of solvent: 40 g sodium desoxycholate (to lyse the cells within the fluid sample); 20 g sodium nitrite (to convert the hemoblogin iron from ferrous to ferric state); and 18 g sodium azide (to form azidmethemoglobin).
  • the method of measuring the amount of blood of a subject within the fluid sample can further comprise delivering an anti-coagulant to the fluid sample.
  • the method of measuring the amount of blood of the subject within the fluid sample can comprise delivering a desired amount of anti-coagulant for each liter of fluid sample that is collected within the suction canister 20 or other container.
  • the anti-coagulant can be Heparin.
  • the method of measuring the amount of blood of the subject within the fluid sample can comprise delivering a selected number of units of Heparin for each liter of fluid sample that is collected within the suction canister 20 or other container.
  • the selected number of units of Heparin can be about 20,000 units of Heparin per liter of fluid sample.
  • any conventional anti-coagulant drug can be delivered in a selected quantity relative to the volume of the fluid sample.
  • the anti-coagulant can be selected from the group consisting of Ethylendiaminetetraacetic acid (EDTA) and Citrate.
  • EDTA Ethylendiaminetetraacetic acid
  • Citrate Citrate
  • a plurality of anti-coagulants can be delivered to the fluid sample.
  • the anti-coagulant or plurality of anti-coagulants can be provided to the fluid sample in any form, including, for example and without limitation, liquid or solid forms.
  • the anti-coagulant(s) can be delivered using a syringe as is conventional in the art. However, it is contemplated that any suitable delivery method can be used. In one exemplary aspect, it is contemplated that a solid form of the anti-coagulant can be fixedly coupled to the internal surface of a suction canister such that the anti-coagulant contacts the fluid sample as it fills up the suction canister. In another exemplary aspect, it is contemplated that a solid form of the anti-coagulant can be fixedly coupled to selected portions of a base element 80 as disclosed herein such that the base element can be selectively inserted within the fluid sample to provide the anti-coagulant to the fluid sample.
  • absorbance data obtained when the fluid sample first enters the canister or other container should be used in determining the hemoglobin concentration, whereas the absorbance data obtained following coagulation of the blood within the fluid sample should be disregarded.
  • the processor can be configured to disregard absorbance data obtained following coagulation of blood within the fluid sample.
  • the method can comprise inserting the light source and the at least one photodetector into the fluid sample before coagulation of the blood within the fluid sample has occurred and removing the light source and the at least one photodetector from the fluid sample and/or ceasing activation of the light source and at least one photodetector after coagulation of the blood within the fluid sample has occurred.
  • the sample fluid within the suction canister 20 can be analyzed using the at least one photodetector 30 disclosed herein.
  • the LEDs configured to emit light at the first wavelength and the LEDs configured to emit light at the second wavelength can be activated in an alternating pattern to permit the at least one photodetector 30 to measure the absorbance of the sample fluid at each wavelength. It is further contemplated that the LEDs can be turned off to assess the ambient light of the room.
  • the disclosed method can comprise selectively positioning the base element within the fluid sample and, after positioning the base element within the fluid sample, selectively activating the light source to transmit light to the at least one photodetector.
  • the blood volume in the suction canister must first be determined.
  • fluid can collect in the suction canister, with some portion of the fluid being blood of the subject.
  • the fluid sample within the suction canister can have a hemoglobin concentration, Hgbc, which will vary with time.
  • the equivalent volume of blood for this hemoglobin concentration can determined by the hemoglobin of the blood, as measured when the blood left the patient (subject), Hgbp(t), which also varies with time.
  • Hgbc hemoglobin concentration
  • Hgbc hemoglobin concentration
  • the equivalent volume of blood for this hemoglobin concentration can determined by the hemoglobin of the blood, as measured when the blood left the patient (subject), Hgbp(t), which also varies with time.
  • t can represent the current time and, thus, t ⁇ 1 can represent the most recent measurement time.
  • EBL estimated blood loss
  • the measurement of patient hemoglobin, Hgbp, at regular intervals can be a challenge because it requires that a subject's blood sample be obtained.
  • the method of estimating the blood loss of a subject can comprise estimating the value of Hgbp. It is contemplated that the estimated blood volume (EBV) of a patient under normal, preoperative conditions can be approximated from the patient's sex, height and weight. It is further contemplated that this EBV value can be updated by tracking the addition of IV fluids (V IV ) and the blood loss (EBL).
  • EBV estimated blood volume
  • V IV IV fluids
  • EBL blood loss
  • the conservation of total hemoglobin from one time to the next can then be expressed by setting the total hemoglobin at any time as being equal to the sum of the total patient hemoglobin and the total suction canister fluid hemoglobin, i.e., the system consisting of the patient's blood and the suction canister blood is closed and thus total hemoglobin (although not hemoglobin concentration) is conserved at all times.
  • EBV( t ⁇ 1)*Hgbp( t ⁇ 1) EBV( t )*Hgbp( t )+[ Vc ( t ) ⁇ Vc ( t ⁇ 1)]*Hgbc( t ) (3) where the first term on the right hand side is the total hemoglobin of the patient at time t and the second term is the total hemoglobin that has entered the suction canister over the time from t ⁇ 1 to t.
  • Hgbp( t ) (EBV( t ⁇ 1)*Hgbp( t ⁇ 1) ⁇ [ Vc ( t ) ⁇ Vc ( t ⁇ 1)]*Hgbc( t ))/EBV( t ) (4)
  • Equation 2 This expression, combined with Equation 2 above, can provide the basis for an iterative algorithm to update the estimate of the patient hemoglobin based on ongoing measurements of volume and hemoglobin from the suction canister. Combining that result with Equation 1 then provides a means to estimate the cumulative blood loss in a patient (EBL).
  • EBL cumulative blood loss in a patient
  • the patient hemoglobin concentration can optionally be determined manually using conventional methods and provided to the processor as one or more inputs.
  • the disclosed devices and systems can be configured to correlate hemoglobin and blood loss data with time. More particularly, it is contemplated that the processor of the disclosed devices and systems can be configured to associate the determined hemoglobin concentrations and estimated blood loss values with respective time points, to thereby permit evaluation of changes in these concentrations and values over time. It is further contemplated that these changes can be correlated with the period during which a medical procedure is performed and, thus, with specific events that occurred during the medical procedure. In exemplary applications, it is contemplated that the processor can be configured to determine the period during which one or more fluids entered a particular fluid sample. In another exemplary application, it is contemplated that the processor can be configured to produce an alert signal when one or more selected conditions are detected by the disclosed device.
  • the processor can be further configured to cause alarm generation means to produce an audible and/or visible alarm in response to detection of the one or more selected conditions.
  • the alarm generation means can optionally be provided in communication with a display and/or user interface as disclosed herein.
  • the alarm generation means can comprise a speaker in communication with the processor.
  • the one or more selected conditions can comprise at least one of: detection of minimally diluted blood entering the canister at a determined rate; a predetermined volume of blood being collected within the canister in a particular time period; or a predetermined quantity of hemoglobin being collected within the canister in a particular time period.
  • the methods disclosed herein can comprise collecting fluid samples in a plurality of containers and selectively positioning a blood measurement device relative to each respective container to thereby provide comprehensive hemoglobin and/or blood loss information based upon all of the fluid in the plurality of containers.
  • the blood measurement devices, systems, and methods disclosed herein are described herein as determining the amount of blood in the fluid sample based upon the concentration of hemoglobin within the fluid sample, it is contemplated that the amount of blood in the fluid sample can similarly be determined using other blood constituents, including, for example and without limitation, white blood cells (leukocytes), red blood cells (erythrocytes), platelets (thrombocytes), blood urea nitrogen, and serum creatinine. It is further contemplated that the equations disclosed herein can be modified to be based on the concentration of one of these blood constituents within the blood of the patient and within the fluid sample.
  • the first wavelength ranges from about 500 nm to about 600 nm
  • the second wavelength ranges from about 850 nm to about 900 nm.
  • the first wavelength is about 525 nm
  • the second wavelength is about 870 nm.
  • the blood measurement device further comprises a base element having first and second opposed members, and the first and second opposed members at least partially define a sample chamber configured to receive a portion of the fluid sample.
  • the light source is operatively coupled to the first member of the base element, and the at least one photodetector is operatively coupled to the opposed second member of the base element.
  • the base element, the light source, and the at least one photodetector are configured for selective insertion within the fluid sample as a unitary structure.
  • the base element is configured for selective attachment to a suction canister.
  • the blood measurement device further comprises a base element, and the light source is operatively coupled to the base element.
  • the base element and the light source are configured for selective insertion within the fluid sample as a unitary structure.
  • the base element is configured for selective attachment to a suction canister.
  • the at least one photodetector comprises an array of a plurality of photodetectors.
  • the light source comprises a plurality of light emitting diodes (LEDs), at least one LED of the plurality of LEDs is configured to emit light at the first wavelength, and at least one LED of the plurality of LEDs is configured to emit light at the second wavelength.
  • LEDs light emitting diodes
  • each LED of the plurality of LEDs is configured for selective activation.
  • the array of photodetectors is radially spaced from the light source by a distance ranging from about 0.05 mm to about 0.2 mm.
  • the blood measurement device further comprises a plurality of pairs of opposed optical fibers, each pair of optical fibers comprises a first optical fiber operatively coupled to a corresponding LED of the plurality of LEDs and a second optical fiber operatively coupled to a corresponding photodetector of the plurality of photodetectors, the plurality of opposed pairs of optical fibers are configured for selective insertion within the fluid sample, and in the operative position, the plurality of photodetectors and the plurality of LEDs are not in fluid communication with the fluid sample.
  • each optical fiber of the plurality of pairs of opposed optical fibers comprises a receiving end and an opposed transmitting end
  • the receiving end of the first optical fiber of each pair of optical fibers is configured to receive light from a corresponding LED of the plurality of LEDs
  • the transmitting end of the first optical fiber of each pair of optical fibers is configured to transmit received light within the fluid sample
  • the receiving end of the second optical fiber of each pair of optical fibers is configured to receive light transmitted by the transmitting end of an opposed first optical fiber
  • the transmitting end of the second optical fiber of each pair of optical fibers is configured to transmit the received light to a corresponding photodetector of the plurality of photodetectors
  • the transmitting end of the first optical fiber of each pair of optical fibers is spaced from the receiving end of a corresponding second optical fiber by a selected distance.
  • the selected distance ranges from about 0.05 mm to about 0.2 mm.
  • the processor is configured to receive at least one input indicative of the volume of the sample fluid.
  • the plurality of photodetectors are spaced relative to a vertical axis, each photodetector of the array of photodetectors is configured to produce a transmittance signal indicative of the transmittance of light measured by the photodetector, and the processor is configured to receive the transmittance signal from each photodetector.
  • the processor is configured to associate the transmittance signal produced by each respective photodetector of the array of photodetectors with a position of the photodetector relative to the vertical axis, and the processor is configured to determine the highest position at which a photodetector of the array of photodetectors produced a transmittance signal indicative of a transmittance of less than 100%.
  • the highest position at which a photodetector of the array of photodetectors produced a transmittance signal indicative of a transmittance of less than 100% corresponds to the height of the fluid sample
  • the processor is configured to determine the volume of the fluid sample based upon the height of the fluid sample.
  • the processor can be configured to receive one or more user inputs, with each input corresponding to at least one of the following variables: Estimated Blood Loss (EBL) of the subject; Volume of the fluid sample; hemoglobin concentration of the blood of the subject; Estimated Blood Volume (EBV) of the subject; and volume of IV fluid administered to the subject.
  • EBL Estimated Blood Loss
  • EBV Estimated Blood Volume
  • a blood measurement system comprises the blood measurement device of any one of the previously described aspects and a suction canister, the suction canister having an outer wall having an internal surface and an external surface, the internal surface of the outer wall defining an interior space configured to receive the fluid sample.
  • the light source is integrally formed with the suction canister.
  • the at least one photodetector is integrally formed with the suction canister.
  • the blood measurement system further comprises a drip counter configured for communication with an intravenous (IV) fluid delivery element, the drip counter is configured to produce a volume signal indicative of the volume of IV fluid dispensed from the IV fluid delivery element and a delivery rate signal indicative of the rate at which IV fluid is dispensed from the IV fluid delivery element, and the drip counter is positioned in operative communication with the processor such that the processor is configured to receive the volume signal and the delivery rate signal.
  • IV intravenous
  • the processor is configured to receive at least one user input, and each user input is indicative of one of: a volume of one or more intravenous (IV) fluids dispensed from an IV fluid delivery element; and a rate at which the one or more IV fluids is dispensed from the IV fluid delivery element.
  • IV intravenous
  • a method of measuring the amount of blood of a subject within a fluid sample comprises operatively positioning a blood measurement device of any of the preceding aspects relative to a fluid sample; and using the blood measurement device to determine the concentration of hemoglobin within the fluid sample.
  • the method further comprises administering one or more reagents to the fluid sample, wherein the one or more reagents are configured to convert hemoglobin within the fluid sample into one of methemoglobin and sulphemoglobin.
  • the method further comprises delivering an anti-coagulant to the fluid sample.
  • the anti-coagulant is heparin.
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